| NPI | 1972722304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 4944) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00043169) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |